Tany Yao: End of an era for integrated EMS and fire

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The current controversy over Emergency Medical Services (EMS) dispatch is really about the revelation by municipalities that they have lost an effective system of emergency management. Efficiencies that were prevalent in communities like Fort McMurray, Red Deer and Lethbridge with the integrated model of EMS and Fire are now only being fully realized with the loss of local EMS dispatch.

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The EMS model that this government inherited involves a single, province-wide EMS system that is managed by Alberta Health Services (AHS). In 2008, this model was proposed by AHS which included the province taking over financial responsibility. Most municipalities agreed to it, albeit without community consultation.

This saved the municipalities well over $200 million collectively. What municipalities didn’t realize at the time was that this represented the beginning of the end of the integrated emergency services model.

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Prior to this change, EMS was a municipal responsibility. The integrated EMS/Fire model that existed in Alberta and in cities like Airdrie, St. Albert and Strathcona County was an agile system that ensured that when you called 911, the responders coming to your door could manage virtually any emergency you might have.

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That is, the responders were paramedics with advanced life support training as well as firefighters with skills in hazard suppression and rescue.

Ambulances head south near Gregoire Lake, near Anzac, Alta., on Wednesday May 4, 2016. Photo by Ian Kucerak
Ambulances head south near Gregoire Lake, near Anzac, Alta., on Wednesday May 4, 2016. Photo by Ian Kucerak Photo by Ian Kucerak /Ian Kucerak/Edmonton Sun

Alan Brunacini is considered the godfather of emergency services. In the 60s and 70s, paramedicine evolved rapidly under his guidance with the Phoenix Fire Department when they hired ex-military medics. They brought their training and experiences from the Vietnam War.

Brunacini saw the value of firefighters with this medical skillset as a natural fit. His studies showed people calling 911 may not understand what resources they need, thus it’s important the responders have a wide spectrum of resources available. Also, the emergencies that firefighters attend tend to inherently have victims requiring medical aid.

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On serious medical calls, extra practitioners on scene to treat a patient is substantially more efficient than a two-man ambulance crew. Paramedic/firefighters, capable of dealing with all aspects of an emergency was key. He called this a responsible job integration.

I remember when I was training to be a paramedic I learned that the average career span of a paramedic was 10 years. Working for EMS-only agencies, I learned that on critical emergencies, that working with only a single partner was extremely difficult.

It’s tough trying to support a patient’s airway, setting up a heart monitor, record vital signs, start an intravenous and so many other things.

At the same time, you’re trying to think of the pathology of what is going on with a patient, sometimes in a poorly-lit setting.

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Time is flying by as you endeavour to get this patient packaged up while carrying a trauma bag, airway kit, heart monitor and 250-pound patient and stretcher.

When I worked in a community that provided an integrated EMS/Fire model, I was suddenly part of a team. A fire truck with my medically trained coworkers could help me and my partner on the ambulance. I could stand back, ask questions, think and direct treatment.

Should there be another EMS call and I was on another call, the fire engine crew were jumping on our backup ambulance and responding to the crisis. We rotated positions, from pump operator to firefighter to ambulance, keeping us fresh and mentally stimulated. Evidently, I lasted 20 years in emergency services.

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Regional Fire Chief Jody Butz and a dispatcher with Regional Emergency Services. Supplied Image/RMWB
Regional Fire Chief Jody Butz and a dispatcher with Regional Emergency Services. Supplied Image/RMWB

Studies from last century indicate a 30 per cent savings in this model versus segregated fire and EMS systems because of efficiencies in manpower and real estate. Alberta is the only province in Canada that embraced the integrated model, although Winnipeg, Kitimat and some communities in Ontario have used variations.

Our province is following a path to a system of segregation where fire and EMS are completely separate, despite the fact that so many communities chose an integrated model which had demonstrated to be very effective.

I support local management wherever and whenever practical, especially resources that manage unplanned, unpredictable and ever evolving emergencies. It’s unfortunate that municipalities chose to abdicate this responsibility, because they lost a system that was operationally and financially more efficient.

Municipalities should ask their citizens the question of whether they support municipal ownership and management of all their emergency services in the next civil election.

Tany Yao is the UCP MLA for Fort McMurray-Wood Buffalo. He has 20 years of experience in emergency services in Ponoka, Westlock, Edmonton, Grande Prairie, Lac La Biche, Peace River and Fort McMurray.

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